Mustafa Erdal

Sprague-Dawley cinsi 60 erkek siçan 30'arli deney ve kontrol gruplarina ayrildi. Her grup kendi içinde vazospazm olusturulan, vazospazin olusturulmayan ve ameliyat edilmeyenler olarak üç alt gruba ayrildi. Vazospazin modelinin uygulandigi gün deney grubundaki siçanlara oral yoldan LO mg/kg siklosporin A verildi. Yedi gün sonunda siçanlar intraperitoneal derin ketamin anestezisi ile öldürüldü ve femoral arterlerinden alinan damar kesitleri doku hazirligindan sonra mikroskop ile incelendi; morfometrik analiz için fotograflari çekildi. Damar duvar ka1inliklarive lümen alani verileri karsilastinldi. BULGULAR

OBJECTIVE S: Pineal region tumors are rarely seen in the central nervous system. The management of the pineal region tumors have remarkably changed since 1980 and different treatment strategies have been suggested. Tn this report, we present a series of pineal region tumours with their follow up that had been operated in our clinic between 1997-2004 by reflecting our surgical and clinical experiences about pineal region tumors. STUDY DESIGN: Twenty-three pineal region tumor patients were evaluated retrospectively who had been operated in our clinic between 1997-2004. 12 of the patients were males and 11 patients were females. The age of the patients were between 10 and 55 (average 29.3). BT, MRI, DSA tumor markers were used for the diagnosis and follow up of the patients. Pineal region surgery was performed for 21 patients and V-P shut was performed for 1 patient. One patient was not operated. As a surgical approach to the pineal region majorly infratentorial supraserebellar approac...

Lecithin-coated microdroplets of methoxyflurane (MOF) have been reported to produce local anesthesia of long duration in rats. The present study was conducted in two phases. The first phase was open label studies in two human volunteers aimed at determining the effective concentration of MOF in human skin. Over the concentration range of 0.3-2.4%, MOF produced local anesthesia to pinprick and cold stimuli within 15 seconds. The duration of the anesthetic effect of 2.4% MOF in the skin of the buttock, forearm and leg was five to eight days. Microdroplets containing isoflurane, a more volatile agent, gave an anesthetic effect that reversed within two to five hours. In the second phase of the study, the safety and efficacy of MOF were compared to phenol in placebo-controlled and blinded studies using indwelling stimulating electrodes. Phenol was destructive to skin at a concentration necessary to obtain a degree of local anesthesia comparable to MOF. The greater part of the anesthetic ...

The open door laminoplasty technique has been previously used to treat cervical spondylotic myelopathy. We adapted this technique for the removal of spinal tumors all along the spinal axis. Between January 2002 and January 2003, 17 patients with various intraspinal lesions underwent open door laminoplasty. The thoracal level was involved in 10 cases, the cervical level in 3 patients and the lumbar level in 4. Location of the tumor was intradural-intramedullary in 7, intradural-extramedullary in 6 and extradural in 4 patients. The histological diagnoses were 4 astrocytomas, 2 meningiomas, 3 neurinomas, 2 ependymomas and one case each with Ewing's sarcoma, metastasis, abcess, hemangioblastoma, arachnoid cyst and lipoma. All lesions were exposed using the open door laminoplasty technique and were successfully removed for intraspinal mass lesions. An average of 3.7 level laminoplasty was performed. Neither spinal malalignment on the coronal plane nor displacement of bone flap (laminoplasty flap) were observed on postoperative CT and MR examinations. No complications due to laminoplasty were encountered. The mean follow-up was 30 months (range 22-48 months). Open door laminoplasty is a simple procedure and has two main advantages over the classical laminectomy procedure; a lower incidence of spinal deformities with or without neurological deficits and an absence of epidural scar tissue. This procedure can be used in all spinal cases with intraspinal mass lesions.

OBJECTIVE AND IMPORTANCE Syringomyelia in association with the Dandy-Walker complex is rare and only 17 cases have been reported, mostly as autopsy findings or incidental reports in series for other conditions. We present a further case report and discuss the possible pathogenetic mechanisms of syrinx formation in the presence of the Dandy-Walker complex. We emphasize the role of foramen magnum obstruction and alteration in cerebrospinal fluid flow dynamics in syrinx formation. The therapeutic importance of disimpaction of the foramen magnum is stressed. CLINICAL PRESENTATION A 39-year-old man presented with headache. As a child, he had had cystoperitoneal and ventriculoperitoneal shunts inserted for hydrocephalus in association with the Dandy-Walker complex. On examination, the patient had limited upgaze but was otherwise normal. Magnetic resonance imaging revealed a large cervicothoracic syrinx and a Dandy-Walker cyst obstructing the foramen magnum. INTERVENTION The cystoperitonea...

Object Chronic subdural hematomas (SDHs) are a local inflammatory process that causes the formation of a granulation tissue often referred to as the external or outer membrane. This membrane has abnormally permeable macrocapillaries. Therefore, exudation from the macrocapillaries in the outer membrane of chronic SDH may play an important role in the enlargement of chronic SDH. In this study the authors investigated the role of exudation in chronic SDH. Methods The authors examined 24 patients (16 men and eight women; age range 38–86 years [mean age 61.4 years]) with 27 chronic SDHs. The clinical status of the patients was evaluated according to the classification described by Markwalder. The diagnosis was established on computed tomography (CT) scans in all cases. The authors also used the Nomura Classification for judging the lesion's appearance on CT scans. Immediately after the diagnosis, all patients were administered 20 mCi (740 mBq) technetium-99m human serum albumin. Four...